Huanglian Jiedu Decoction (HJD), one of the classic recipes for relieving toxicity and fever, is a common method for treating sepsis in China. However, the effective components of HJD have not yet been identified. This experiment was carried out to elucidate the effective components of HJD against sepsis. Thus, seven fractions from HJD were tested using a biosensor to test their affinity for lipid A. The components obtained that had high lipid A-binding fractions were further separated, and their affinities to lipid A were assessed with the aid of a biosensor. The levels of LPS in the blood were measured, and pathology experiments were conducted. The LPS levels and mRNA expression analysis of TNF-α and IL-6 of the cell supernatant and animal tissue were evaluated to investigate the molecular mechanisms. Palmatine showed the highest affinity to lipid A and was evaluated by in vitro and in vivo experiments. The results of the in vitro and in vivo experiments indicated that the levels of LPS, TNF-α and IL-6 of the palmatine group were significantly lower than those of the sepsis model group (p<0.01). The group treated with palmatine showed strong neutralizing LPS activity in vivo. The palmatine group exhibited stronger protective activity on vital organs compared to the LPS-induced animal model. This verifies that HJD is a viable treatment option for sepsis given that there are multiple components in HJD that neutralize LPS, decrease the release of IL-6 and TNF-α induced by LPS, and protect vital organs.

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Objective. To investigate the pulmonary function responses to respiratory muscle training (RMT) in individuals with tetraplegia and provide a systematic review of the included studies. Methods. Computerized retrieval of randomized controlled trials (RCT) in PubMed, Embase, and the Cochrane Library on the improvement of respiratory function in patients with spinal cord injury by RMT was conducted until May 2019. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. Articles were scored for their methodological quality using the Cochrane Collaboration risk of bias assessment tool. Results. Sixteen studies were identified. A significant benefit of RMT was revealed for five outcomes: force vital capacity (FVC, WMD: -0.43, 95% CI -0.84 to -0.03, P=0.037), vital capacity (VC, WMD: -0.40, 95% CI -0.69 to -0.12, P=0.006), maximal voluntary ventilation (MVV, WMD: -5.89, 95% CI -10.63 to -1.14, P=0.015), maximum static inspiratory pressure (MIP, WMD: -13.14, 95% CI -18.01 to -8.27, P<0.001), and maximum static expiratory pressure (MEP, WMD: -13.08, 95% CI -23.78 to -2.37, P=0.017). No effect was found for forced expiratory volume in 1 s (FEV1). Conclusion. Our findings demonstrate that RMT can effectively improve spinal cord injury pulmonary function of the patient, which is marked by increasing respiratory strength, function, and endurance. Limited by the quantity and quality of the included studies, the above conclusion needs to be verified by more high-quality studies.